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Zoster
Lecture 14
9
Pharmacology
Professional
03/31/2013

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Term
What is the chicken pox?
Definition
- Onset at 5-9 in Jan-May from the Varicella virus from direct contact with fluid from vesicles, respiratory droplets, direct contact. Household transmission 80-90%
**Prodromal phase --> itchy rash
Term
What are signs of chicken pox?
Definition
- Up to 500 itchy blisters, severe scratching. Starts on scalp/trunk
**Incubation 11-21 days. Infectious 2-4 days before rash until lesions crusted
Term
What can be used to treat chicken pox?
Definition
- Acyclovir up to 800 mg 5x/day. Shortens viral shedding, more rapid healing
- Pregnancy - Ig or acyclovir x7 days
- Itching - Colloidal oatmeal, pramoxine
Term
What can be used for OTC management of chicken pox?
Definition
- Antihistamines - benadryl, hydroxyzine
- Fever - APAP, IBU
- Astrigent - calamine
Term
What vaccines exist for zoster?
Definition
- Varicella
- Varivax - one dose at 12 months, booster at 4 years = 90% immune
- Zostavax - for over 50, reduces risk by 50%
Term
What is shingles?
Definition
A viral infection from zoster that hides in the nerve roots
**Risk factors: Aging, immunosuppression, cancer, risk of recurrence.
Term
What is the recommendation for the shingles vaccine?
Definition
- Age 50 or older
Term
What symptoms occur with shingles?
Definition
- Stabbing nerve pain - PHN
- rash clears in 3-4 weeks, pain may remain
- may reoccur
Term
What is the treatment for shingles?
Definition
Start within 72 hours of onset:
- Acyclovir 800 5x daily
- Famciclovir 500 TID x7
- Valtrex 1g TID x7
- Pain - up to morphine
- Prednisone for 3 weeks
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